Objective To explore the effect of mucle force on contact force, peak pressure and contact area of foot joint in in vitro biomechanical experiment of foot and ankle, so as to provide references for choosing appropriate loading modes. Methods In neutral position of the ankle joint, fresh calf and foot specimens were simulated with or without mucle force loading. The contact force, peak pressure and contact area of the 1st metatarsophalangeal joint, the 2nd metatarsophalangeal joint, the 1st tarsometatarsal joint, the 2nd tarsometatarsal joint, the medial cuneonavicular joint, the intermediate cuneonavicular joint, the talonavicular joint, the calcicocuboid joint, the subtalar joint ( posterior articular surface) and the tibiotalar joint of normal foot under loading were measured, the results are compared and analyzed. Results Under muscle force loading, the contact force of the 1st metatarsophalangeal joint, the 2nd metatarsophalangeal joint, the 1st tarsometatarsal joint,the 2nd tarsometatarsal joint, the medial cuneonavicular joint, the intermediate cuneonavicular joint, the talonavicular joint and the tibiotalar joint were significantly greater than those without muscle force loading (P<0. 05), and the change percentages were 719. 28% , 311. 37% , 128. 67% , 50. 82% , 54. 89% , 57. 63% ,79. 98% and 50. 34% , respectively. The peak pressures of the 1st metatarsophalangeal joint , the 1st tarsometatarsal joint and the talonavicular joint under muscle force loading were significantly higher than those without muscle force loading ( P < 0. 05), and the change percentages were 176. 14% , 62. 91% and 40. 07% ,respectively. The contact area of the 1st metatarsophalangeal joint, the 1st tarsometatarsal joint, the intermediate cuneonavicular joint and the subtalar joint ( posterior articular surface) under muscle force loading increased significantly (P<0. 05), and the change percentages were 132. 20% , 55. 41% , 30. 97% and 26. 87% , respectively. Conclusions In biomechanical experiment of foot and ankle specimens, muscle force loading has a significant effect on contact force, peak pressure and contact area of each foot joint, especially the forefoot.Therefore, it is necessary to consider the effect of muscle force loading on stress of foot and ankle in the study ofrelated in vitro specimens

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

Objective:To explore the effect of self-made Yiqi Yangyin Decoction on immune function, serum tumor markers and toxic and side effects of chemotherapy in patients with advanced gastric cancer chemotherapy.Methods:A total of 88 patients with advanced gastric cancer who met the inclusion criteria in the hospital between December 2018 and December 2020 were divided into two groups according to the random number table method, with 44 in each group. The control group was treated with chemotherapy, and the observation group was given self-made Yiqi Yangyin Decoction on the basis of the control group. The two groups were treated for 4 consecutive cycles with 3 weeks as 1 cycle. The Traditional Chinese Medicine (TCM) symptoms were scored before and after treatment, and the levels of IgG, IgA and IgM were detected by immunoturbidimetry. The levels of carcinoembryonic antigen (CEA) and cancer antigen 125 (CA125) were detected by ELISA. The gastrointestinal reactions, thrombocytopenia, anemia, leukopenia and neurotoxicity were recorded and evaluated during treatment, and the clinical efficacy was assessed.Results:The total effective rate was 81.8% (36/44) in observation group and 61.4% (27/44) in control group (χ 2=4.53, P<0.05). After treatment, the scores of stomachache and gastric distension, poor appetite, shortness of breath, and drooping spirit in observation group were significantly lower than those in the control group ( t=17.28, 11.91, 5.02, 5.65, all Ps<0.001) while the levels of serum IgG [(9.39±0.46)g/L vs. (8.54±0.23) g/L, t=10.96], IgA [(1.35±0.42) g/L vs. (1.07±0.15) g/L, t=6.90] and IgM [(0.92±0.09) g/L vs. (0.78±0.10) g/L, t=4.17] were significantly higher than those in the control group ( P<0.01). The levels of serum CEA [(9.07±1.01) μg/L vs. (14.89±2.13) μg/L, t=16.38] and CA125 [(24.87± 4.68) kU/L vs. (30.75±5.33) kU/L, t=5.50] were significantly lower than those in the control group ( P<0.01). During treatment, the toxic and side effects of gastrointestinal reactions, thrombocytopenia, anemia, leukopenia and neurotoxicity were significantly lower in the observation group than those in the control group ( Z=18.52, 2.54, 3.12, 3.84, 2.34, P<0.05). Conclusion:Self-made Yiqi Yangyin Decoction can improve the TCM symptoms, enhance the immunity, reduce the levels of serum tumor markers, and relieve the toxic and side effects of chemotherapy of patients undergoing chemotherapy for advanced gastric cancer.

Objective　To investigate the expression level and clinical significance of LncRNA RP11-147L13.8 in peripheral blood of patients with acute cerebral infarction.Methods　Fifty patients with acute cerebral infarction (case group) and 50 patients without cerebral infarction (control group) hospitalized in our department were randomly selected,and the expression level of LncRNA RP11-147L13.8 in peripheral blood was detected by real-time fluorescence quantitative PCR in case group and control group,and the correlation between LncRNA RP11-147L13.8 and cerebral infarction was investigated.Results　〖JP2〗The expression level of LncRNA RP11-147L13.8 in peripheral blood of patients with cerebral infarction was significantly higher than that of control group (P<0.05).The expression level of LncRNA RP11-147L13.8 in peripheral blood was positively correlated with the occurrence of acute cerebral infarction,and LncRNA RP11-147L13.8 was an independent risk factor for the occurrence of acute cerebral infarction.LncRNA RP11-147L13.8 in the diagnosis of acute cerebral infarction had an area under the curve of 0.750,a critical value of 0.40,a sensitivity of 0.66 and a specificity of 0.74.Conclusion　LncRNA RP11-147L13.8 is differentially expressed in cerebral infarction,which is expected to become a potential biomarker for the diagnosis of acute cerebral infarction and provide new ideas for clinical diagnosis and treatment.

Objective:To investigate the effects of miRNA-26a (miR-26a) on the target gene HMGA2 on the proliferation and migration of hepatoma cells and the underlying mechanism. Methods:Liver cancer tissue samples ( n = 30) and adjacent normal tissue samples ( n = 30) pathologically confirmed by Wenzhou Hospital of Traditional Chinese Medicine between September 2018 and September 2019 were collected. MiR-26a mimics, control mimics (miR-Control), high-mobility group A2 protein (HMGA2) siRNA or negative control siRNA (Control) were transfected into human hepatoma cell lines HepG2 or Huh-7 cells. The expression of miR-26a in hepatocellular carcinoma tissue was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR). MTT assay and scratch test were performed to determine the ability of cell proliferation and migration. RT-qPCR and western blotting were performed to detect miR-26a and HMGA2 mRNA expression. The relationship between miR-26a and HMGA2 mRNA was analyzed using Bioinformatics and luciferase reporter gene assay. Results:RT-qPCR results showed that the expression level of miR-26a in hepatocellular carcinoma tissue was 0.11 ± 0.02, which was significantly lower than that in normal tissues (0.25 ± 0.03, t = 21.268, P < 0.05). The expression level of miR-26a in stage III + IV was 0.05 ± 0.01, which was significantly lower than that in stage I + II (0.09 ± 0.01, t = 15.491, P < 0.05). Cell experiment showed that in the miR-26a group, the proliferation ability of Huh-7 cells was (3.10 ± 0.30) and (4.10 ± 0.40), and the proliferation ability of HepG2 cells was (3.08 ± 0.31) and (4.11 ± 0.40), which was significantly lower than that in the control group [(3.90 ± 0.40), (5.50 ± 0.60), (3.92 ± 0.41), (5.49 ± 0.58), t = 8.764, 10.634, 11.148, 10.728, all P < 0.05]. In the miR-26a group, the migration ability was (0.50 ± 0.06), (0.65 ± 0.07), which was significantly lower than that in the control group [(1.00 ± 0.10), (0.96 ± 0.10), t = 23.483, 13.910, both P < 0.05]. Bioinformatics and in vitro experiments showed that HMGA2 was a direct target of miR-26a. Restoring the expression of HMGA2 in miR-26a mimics-transfected cells, compared with that in the miR-26a group [(0.24 ± 0.02), (0.31 ± 0.03);(0.45 ± 0.05)], could significantly reverse the inhibitory effect of miR-26a on tumor cell proliferation and migration [(0.31 ± 0.03), (0.40 ± 0.04);(0.93 ± 0.08), t = 10.634, 9.859, 27.868, all P < 0.05). Conclusion:miR-26a inhibits the proliferation and migration of hepatoma cells by directly targeting HMGA2. The abnormal decrease of miR-26a and the increase of HMGA2 may be the important factors that participate in the occurrence and development of liver cancer.

Objective:To investigate the pathomorphological characteristics of colorectal adenoma with submucosal pseudoinvasion and to summarize the corresponding pseudoinvasion patterns.Methods:The clinicopathological data of 9 cases of colorectal adenoma were collected at 989 Hospital of PLA Joint Logistics Support Force (4 cases) and Beijing Chaoyang Hospital, Capital Medical University (5 cases), from 2016 to 2019. retrospectively, and the histomorphological characteristics and immunophenotypes were analyzed, and discussed in light of the relevant literature.Results:There were 8 cases of adenoma with stalk. Tumor glands were found in the submucosa at the head end of adenoma, similar to infiltrating adenocarcinoma. The structure and cellular morphology of submucosal glands were very similar to the intramucosal tumor while the local submucosal tumor showed continuity with the intramucosal tumor. The submucosal tumors were lobule-like or nest-like with clear boundary. The outline of the gland was smooth and blunt-round, and there was loose fibromyxoid stroma around the gland, similar to the mucosa propria stroma. Some cases of the submucosal glands were cystic dilated with mucocele formation and hemosiderin deposition. One case with broad stalk-base showed an elevated adenoma with local high grade dysplasia involved in the aggregated lymphoid nodule, forming the lymphoglandular complexes, simulating invasive adenocarcinoma with associated submucosal lymphoid aggregates. Submucosal cancer tissue and intramucosal cancer tissue had continuity, and their morphology was the same. The submucosal tumor was round in the outline, smooth and blunt in the edge, and surrounded by lymphoid tissue. There was no stromal response around the gland to promote the proliferation of connective tissue, neither was there single-cell or small-cell cluster, sharp angle branch of gland, or vascular infiltration.Conclusions:There are two unique morphological patterns in colorectal adenoma with submucosal pseudoinvasion. Morphologically, the data show that one is lobular-like pattern, and the other is lymphoglandular complexes-like pattern. The main features of the two patterns are the same-morphology and continuity of submucosal tumor and intramucosal tumor. The pushed glands were surrounded by the intrinsic membrane stroma and muscularis mucosae in proper order, lacking the typical morphological characteristics of invasive adenocarcinoma.

Objective: Analyze the genetic characteristic of Hemagglutinin(H) gene of measles viruses isolated in Henan Province in 2017. Methods: Swab samples collected from 7 lab confirmed measles cases, and we got the measles virus by Vero/Slam inoculation. Fragment of H genes were amplified by reverse transcription polymerase chain reaction(RT-PCR), then the PCR products were sequenced and analyzed. Results: The age of the 7 measles confirmed cases were between 1 and 50 years old, and all of them were males. All the 7 measles viruses were identified as H1a genotype, and the average distance of the nucleotides and the amino acids was 0.005, respectively. Compared with the Shanghai-191/China-vaccine, there were some changes in isolated virus, such as 240^th, 397^th and 381^st sites in the amino acid sequence. Conclusion The measles genotype which isolated in Henan Province in 2017 was H1a. There were some difference from Shanghai-191/China-vaccine in the nucleotides sequence of H gene, which suggested that it′s necessary to strengthen the monitor the variation of measles virus.

In the course of pathophysiology,we gave full play to the advantages of network teaching platform to integrate teaching resources,broaden students' learning pathways,and enhance the interaction,which could benefit teachers as well as students.The traditional teaching mode and concept were changed by using Computer Aided Instruction (CAI) and relying on the network platform to carry out multi-level teaching methods such as flipped classroom and Task-Based Leaming (TBL).We gradually conducted formative assessment to promote learning.Thus,the interest and the enthusiasm of students in learning were elevated and the independent learning capability were cultivated.

Objective To analyze the genetic characteristics of mumps virus ( MuV) isolated from an outbreak in Henan province in 2016 and to provide reference data for the control of mumps in Henan prov-ince. Methods Swab specimens were collected from a mumps outbreak in Henan province in 2016. One virus strain was selected for whole genome sequencing after virus isolation and genotyping. MEGA7. 0 soft-ware was used to construct phylogenetic tree, to calculate P-distance and to analyze the characteristics of genes encoding small hydrophobic protein ( SH ) , fusion protein ( F ) and hemagglutinin neuraminidase ( HN) . Results Five swab specimens were collected in the outbreak and five MuV strains were successfully obtained. Phylogenetic analysis showed that all of them belonged to genotype F with a P-distance of 0. 047 (0. 046-0. 049 ) with the reference strain. The P-distance among the five MuV strains was 0. 001 ( 0-0. 003). Results of the whole genome sequencing of one MuV strain showed that the P-distance with the ref-erence virus was 0. 053 (0. 018-0. 072) and the smallest P-distance with genotype F was 0. 018. Compared with the vaccine strain (HQ416907. 1), the amino acid at 28-30 site of SH protein was IML. The 91, 195 and 383 amino acid sites in F protein were related to the pathogenicity of MuV, but no mutations were found in these sites. Some mutations were found in HN protein, such as P354Q, E356D and K464N, which were associated with the immunological characteristics of MuV. Conclusions MuV strains isolated from the out-break in Henan province in 2016 belonged to genotype F. The genetic characteristics of these MuV strains were similar to those prevalent in other provinces of China.

Objective Analyze the genetic characteristic of Hemagglutinin(H) gene of measles viruses isolated in Henan Province in 2017. Methods Swab samples collected from 7 lab confirmed measles cases,and we got the measles virus by Vero/Slam inoculation. Fragment of H genes were amplified by reverse transcription polymerase chain reaction(RT?PCR), then the PCR products were sequenced and analyzed. Results The age of the 7 measles confirmed cases were between 1 and 50 years old,and all of them were males. All the 7 measles viruses were identified as H1a genotype,and the average distance of the nucleotides and the amino acids was 0.005, respectively. Compared with the Shanghai?191/China?vaccine, there were some changes in isolated virus,such as 240th, 397th and 381st sites in the amino acid sequence. Conclusion The measles genotype which isolated in Henan Province in 2017 was H1a. There were some difference from Shanghai?191/China?vaccine in the nucleotides sequence of H gene,which suggested that it's necessary to strengthen the monitor the variation of measles virus.